Increased complication rates associated with laparoscopic surgery among patients with genital tuberculosis

Abstract

Objective: To compare the complications and surgical difficulties encountered during laparoscopy between women diagnosed with and without genital tuberculosis (TB).

Methods: Retrospective review of the records of women diagnosed with and without genital TB who underwent laparoscopy primarily for infertility and chronic pelvic pain from January 2006 through July 2009. Genital TB was diagnosed by laboratory studies and endoscopic findings.

Results: A total of 313 women were included in the study: 87 (27.8%) with genital TB and 226 (72.2%) without. Laparoscopy was performed in 48 (55.2%) patients with genital TB and 19 (8.4%) without; laparoscopy with hysteroscopy was performed in 39 (44.8%) with the disease and 132 (58.4%) without. Although individual complication rates were all higher in the genital TB group, significant differences were seen for inability to see the pelvis (10.3% vs 1.3%, P=0.027), excessive bleeding requiring transfusion (2.3% vs 0%, P=0.045), and peritonitis (8.0% vs 1.8%, P=0.037). Other complications encountered were inability to create pneumoperitoneum, bladder injury, trocar site discharge, and need for laparotomy.

Conclusion: Laparoscopic surgery may be associated with increased complication rates in patients with genital TB compared with those without the disease.